Trans folks seeking out-of-state health care must take big precautions to avoid legal surveillance

As bans on gender-affirming care and abortion sweep the nation, Americans in conservative-leaning states must increasingly travel to more progressive states to obtain this crucial health care.

While progressive leaders are doing what they can to create sanctuary states and protect those seeking care, a new report from the Surveillance Technology Oversight Project (S.T.O.P) highlights the way conservative states can utilize surveillance tools to track their residents’ movements.

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“Prosecutors and state officials can use countless surveillance tools, from automated license plate readers to street cameras, to identify and track those seeking, facilitating, or assisting out-of-state care,” the report explains. “They can also weaponize commercially available surveillance data. S.T.O.P. used one data broker’s platform to place the homes of visitors to an Illinois abortion clinic across the river in Missouri, where abortion is banned.”

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Prosecutors have long used data cell phone data to track a person’s movements – from their text messages to their search history. But now, data from companies — like Uber, Lyft, and even bikeshare apps — can be used to track someone to an out-of-state clinic or medical center.

The report shows that while long-distance travel can easily reveal a person left the state, it has a low risk of confirming a person’s specific whereabouts, as a plane, train, or bus can’t lead to a person’s final destination. But what the report refers to as “last mile travel,” that final ride to the clinic, itself, is where the risks get high if you’re not careful.

“Car travel is especially susceptible to surveillance,” the report states. “Worse yet, car data lends itself to profiling yet unknown healthcare seekers… Automated surveillance of cars is now pervasive, making it nearly impossible to travel untracked in a car.”

The report says very high-risk options include rideshare vehicles, private vehicles, taxis, scooter shares, and bikes shares. Low-risk options include municipal buses and subways. Another option S.T.O.P. suggests is driving to a friend’s home and taking a bus from there.

When it comes to accommodations, the lowest risk is staying in a private home, followed by a short-term rental. Hotels and motels contain a “moderate” risk of confirming one’s destination to law enforcement.

What’s more, state attorneys general that have outlawed abortion and/or gender-affirming care have made it clear that preventing folks from violating these laws is a priority. This week, Republican attorneys general from 19 states sent a letter to the Biden administration demanding access to the private medical records of citizens who cross state lines to access abortion services or gender-affirming care in states where such care is legal.

The report’s conclusion declares that “state bans on vital healthcare are creating a crisis right here in the U.S. State laws that counter these bans by creating healthcare sanctuaries help travelers.”

“But as long as states, private companies, and federal agencies continue to restrict or prohibit anonymous travel and cash payment, and collect and leak healthcare seekers’ personal data—travel data, healthcare data, smartphone data, payment data— they will not effectively shield healthcare seekers from investigation and prosecution,” the report added.